Constipation Part 1: What’s Normal, What’s Not and Why It Matters

Podcast Intro and Sponsor Message 0:00

Constipated kid, it's not just a phase. You're listening to the Get to The Root podcast with hope for healing. And today is part one of constipation. Dr. Paula Krebsat breaks down why childhood consti- patient is so common and what normal poop looks like. Why quick fixes like Miralax aren't always the answer and simple fixes you can try tonight. Let's get to the root. This podcast is for education and encouragement. Please consult your health provider for personalized medical advice. Now a note from Dr.

K about our sponsor. Every patient's story is unique, and so is their DNA. At Hope for Healing, we used advanced SNP panels created in partnership with Legrand to uncover the genetic clues that guide us toward more personalized care. This week, were taking a closer look at the GSTP1 gene, which tells the body how much glutathione is made in the gut. Without enough glutothione, you may become constipated. We're grateful to Fagran for sponsoring this podcast and for helping us bring hope for healing from the inside out.

Thank you so much for meeting with us, Dr. K. I remember the first time, I think it was like day one of me working at Hope for Healing.

Why Constipation Is Common in Kids 1:14

There's so much about the Bristol stool chart that I learned and so about constipation. So I'm really excited to unpack this with you because I think it's something that can so easily be overlooked as a cause of so many other problems. But let's just start off with the obvious. Why is constapation so common with kids today? And why is it so oftenly brushed off as super normal? Well, I think a lot of our foods have things in it that make our poop like glue. It's so gluten causes gluey stools. So there's a lots of toxic things our food.

Really, we've talked about non-food items. Just a lotta junk that binds you up and just not a gotta movement and things like that. I love it. A lot more sedentary, the things we eat, and we're going to get a lot into that. So parents frequently though, like if they're gonna go the allopathic way, they are told that this is like, oh, it's just a phase, or you know what, just take some Murlax. Why is this not the greatest approach to this idea? Yeah, well, one of the things that I was told and I even told people before I knew any better was, oh, Miralax, which is polyethylene glycol, yeah, is inert, meaning it just stays in the gut and just draws water into the bowel.

Why Miralax Is Not the Best Quick Fix 2:53

But by definition, if you've got constipation, your bowel is not moving like it should, you have what's called increased intestinal permeability. So by golly, are absorbing that garbage and who wants to eat something or drink something that's kind of related to the antifreeze family. So, we don't want to put Mirlax in our body because it's not inert. There are parts of it that get absorbed, and that's a not a good thing. Oh, well, that is so good to know. And yeah, I guess if I can't pronounce it or spell it, then I probably don' t want it in my body.

That's right. So let's start with there. What exactly then is constipation? What would be the definition of constepation. Okay, well, there's a little bit of variability that's considered normal, but why don't we start from birth on? So, let's say a breastfed or a formula-fed baby. Breastfed babies typically poop every time they eat, okay, so that is normal. And the consistency of the stool is seedy and mustardy. But around four to six months of age, the frequency that a child poops that is breastfed drops way down.

What Normal Poop Looks Like by Age 4:07

Why is that? That's because if you're solely breast fed, then nutrients within the breast milk, that body just absorbs all that goodness so you don't make as much stool. So a baby, we have moms and dads say, oh, my child's constipated. Well, tell me what you mean. Oh, they haven't pooped for four or five days. And then we ask, well, are they comfortable? They're not like wiggly and act like they hurt? Their belly's not distended? No. Then when they finally do poop, it's creamy and soft and it is this mega blowout that goes up the front and the back of the diaper all over the place.

And it's normal for a breastfed baby to go as long as, I know this sounds crazy, 10 to 14 days without pooping. And when they go, it is soft and it this ginormous volcano of soft, seedy, mustardy poop. as you age, and then you start to eat solid food, you should have a soft-serve banana sausage-looking poopie. But if a child's in a diaper, it needs to look like kind of like a Soft Cow Patty, okay? Okay. No, I love it. Yeah, so this is reality because if you have a baby that's pooping every time you feed them, then all of a sudden they don't poop for seven days.

So if they act uncomfortable, we stimulate the booty-tooty, you know, and just kind of see how they do and then big blowout. There's also little exercises that, little tummy massage to get them to go. Anyway, but then once, you know, a child is eating solid foods, pretty much with every meal, it's normal to poop one to three times a day. when they're able to go into the toilet, it should sink and it look like little snakes and should have the caliber of like, you know, half to an inch diameter and shouldn't clog the toilets.

So that's what's normal. Now, you should usually stool every day, but if people have, and we can provide the Hope for Healing Poopy Doopy chart, our little modified poop chart as a freebie for you to look at, if a child or an adult poops every other day but it's soft, it is type 3 or type 4 and it doesn't hurt their bottom coming out and they're not uncomfortable otherwise, then that may be their norm, but it's okay to poop one to three times a day that's soft and sinks. Okay. So what I love that you said, even though like we giggle because it is one of those like, we're describing what it looks like.

I loved the calm and peace that can add to anybody listening or watching to this episode that didn't know some of these things were normal.

Signs a Child May Be Constipated 7:10

But what are the things that we would start to see that? We would want to have more, maybe some questions that this may be starting to lead towards constipation. And, you know, it's interesting little kids, they may not know what normal is because they've had dysfunctional stools all their life. So I think really good questions are is, asking how often they poop, but also showing them a chart and what's it look like if you look at it. And, you know, they giggle and they might look away, but I'm like, well, hey, everybody sleeps and everybody poops.

We got to know this is important. So it can be fun. But I always ask kids, does it ever hurt your bottom when it comes out? And so if they kind of lean into that, if their contemplative about it, Well, yeah, it does sometimes. And I said, so when that happens, what's typically going on in your life? So you just ask a few more questions. I love that. Well, because you're inviting, first and foremost, you are inviting the child into the space to be observant of their body because just because they're children doesn't mean that they don't know and that we just have to learn how to ask the right questions.

And I've always loved that in sitting in your appointments. Are there if I guess maybe first starters if it's a little uncomfortable are there positions that they could try that could kind of help the body move a Little bit easier. Mm-hmm. Yeah So, you know before we had toilets we would squat out in the woods, okay? So if you have the knees slightly above the hip level, so we like the squatty potty at Hope for Healing, and we have them in all of our bathrooms, And you can have one for a grownup and then get the next level, but with the knees slightly above the level of the hips.

Toilet Positioning and Bathroom Habits 9:08

And then also, if you gently put the knee together, it opens up the rectal vault so that stuff comes out easier. Because it shouldn't hurt, and you just sit and boom, then you're done. You should not be on the toilet very long. Yes! You get on and you get off. You don't want to sit there very long because if you strain you can get built up of blood in the veins and that can lead to hemorrhoids even in children. They can be internal and external. It's painful and yucky. So painful, yeah. Well, and okay, so you should be on and off for people who I know this is so funny because it's a comedy skit of almost of people to about how long they're on the toilet.

Right. What is too long? Honestly, if you talk to pelvic floor therapists, you should basically be able to get on and go within three minutes. Many times less than that. Be a lightning pooper. Okay, you know, just get on, get off and it's like you're done, so then, and listening to the body to go when you feel like, we've all watched little kids that are becoming aware of their body and they have a diaper on and their toddling around. and they look at you funny and go behind a chair and squat and poop in their diaper.

It's like they're getting the feeling of it. So it's just like staying in tune. You know the whole thing. Having a childlike attitude. Listen to your body. Don't suppress it, don't squeeze it in, and don' do the potty dance. That's another thing. Parents, if you're watching your kids kind of, you know, they're playing a game or they are doing something and they kind rocking and moving around, there may be stool holding. So it's like, hey, let's go to the bathroom. Don't say, do you have to go the the bath just say it is time to let go and make it a positive experience.

Let's get in there and get that out. Well, and that's exactly what I was going to say. So if we are noticing these behaviors, we first and foremost want to create a safe environment in the bathroom.

Hydration and Fiber Basics 11:34

And that they can go as easily and not this is just this open environment. If I think I need to go, that is where we're going go and we going practice. I love that environment! But if we are starting to have different tendencies or we're noticing their answer is uncomfort or maybe they're making a face that they are experiencing discomfort, what are some of the first things that we should try if think our child is experiencing consummation? You know, typically parents and the kids have the answers, but you know if they're school age they may not want to poop at school.

That's a big one. And then the the two biggies are hydration, are you dehydrated, and fiber. So if there in a different environment they are not drinking as much water and if their not getting fiber, so you want a drink water. And then if your child or you doesn't like water, think about fruit or vegetable infusions that taste good. And, you know, a lot of people go, well, I give my kid a sippy cup with juice in it. Well, why don't you do this? Take a sippy cup and put a slice of fruit in and you still get that natural fructose from the fruit.

But you're not separating the juice from the fiber. And then when we think about fiber, you know, I love summertime, but I also love the fact that with some of our big warehouse places like Costco and Sam's, You can buy organic berries year round that are in the frozen fruit department. So red raspberries have more fiber per cup than any other fruit. And if the kiddo doesn't like that, go back to good old apples, organic apples. So eating a few apple slices with some nut butter. Also, a really good source of fiber and naturally occurring sugar is majeure dates.

So eating a mageure date, you know, that's a great way to get fiber in too. Water, so they're not dehydrated. And parents will tell me all the time, I start asking these kids about their poop in their well child visit and the parent will say, well, they don't tend to drink as much water at school. They come home and their water bottle is like halfway full. Right. So hydration, fiber, and the position. And that's a good place to start. Where are you or where are not pooping? It could be as simple as, I don't like to use the potty at school.

I love that. Okay, so you talked about hydration. There is so many different ways that you can Google on what hydration looks like. Is there a formula that would recommend for someone to say, like, this is what, hydration is a good starting place? You know, after a child has weaned off a formula or breast milk, the main thing that they should be drinking is water. And so if you take your weight in pounds and you divide it in half, that's about how many ounces of water you should consuming in a day.

Eating Order, Enzymes, and Digestion 14:52

And when you think about children and you're wanting them to be dry at night, you want almost all of that fluid to go in before dinner if you are working on nighttime potty training. Oh, yeah. No, that makes perfect sense. And also, does that kind of play into the way that we eat? Because I know they do cut off times. What people are calling intermittent fasting is really just sometimes the starting grace of, I shouldn't eat after seven, eight o'clock, and I should eat again until. Does that affect anything with constipation?

It can, but not usually. But one thing I would remember as far as the whole constipation and how our GI tract functions is that if you don't drink while you eat and you fluid load before you ate, and if your eating any fruit with a meal, So you don't have a water glass, you know, like they serve you at restaurants. It's like, no, thank you. I don''t drink while I eat. But or I fluid load before my food arrives. And then if I have fruit, I ate the fruit first because there's enzymes in the So if you're giving a child a little lunch to go to school or you are eating dinner and you've got fresh fruit, you like, well, here, let's eat our pineapple first, or let us eat blueberries, eat the few little red raspberries, and now let eat this.

Let us our chicken, our lentils, quinoa, whatever. So that will give the gut enzymes and not diluting all those enzymes by drinking the entire time. And that will help you not get constipated. No, that's really cool. So it's not the timing, but almost the order of how you eat, like the orders. You're drinking fluids, which can feel silly because you're like, oh, fruit is like fruity. It's the sweet part, But it is actually helping the body prepare for ultimately getting everything that it needs to get.

And so that actually leads us to the enzymes and everything. There's this big word that everybody talks about all the time. I think moms or dads who are listening will know about it from their personal selves where it's like detoxification. Oh, we're going to go on detoxes.

Detoxification and Genetic Factors 17:28

But where does detoxication come into play with constipation? Well, detoxification means removing garbage, okay? So how does our body detoxify? We pee, we poop, and we sweat and breathe things out. So I always use the illustration with children, what would happen if nobody dumped the trash in your kitchen? And these kids get it. They're like, oh, man, it would fill up, the dog would get in it, and then it will start to stink. And I'm like what if nobody dumped the trash at all? What would happen in the kitchen?

It would go everywhere, wouldn't it? And what would happened? So that's what happens to our body when we are not taking the trash out on a regular basis. So, that is why we make such a big deal about finding out when do you poop? What does it look like? Does it hurt you? And so, detoxification is the elimination of waste. And, so our major detoxication organs, as we said, are our GI tract, our bladder, skin, and respiratory tract. Are there people who are prone to not being capable of detoxing the way, like genetically not be capable to detox the ways that our bodies would typically be designed or the that in a perfect world it would work this way?

Yeah, so typically people that struggle with constipation, if they have impaired genetic detoxification, they lack an enzyme. The gene name is GSTP1. It concentrates itself in the gut wall. And so a lot of times, just by taking oral glutathione, the detoxication end product, that helps people poop. Oh wow, that's really cool. And so how does someone like find out if they, is that something that, Is that a test or how do they find if that isn't working properly? Well, we have like a single little swab or you can do what's called a detoxification panel.

And then if you have that, you know, like maybe with both copies from both parents, if someone has that they tend to have kind of like a lot of things, but constipation is a biggie. They may have lots of sinus infections and ear infections, and asthma. They may have urinary tract infections or skin infections like bad diaper rashes and little babies that struggle with constipation too. You know, you don't want those rabbit pellets and those hard things. And it's like by taking or applying glutathione, it is a game changer.

It just is so helpful because in essence, what is the leaky gut? What is increased intestinal permeability? It's a lack of glutathione in the entire GI tract. It is lowering inflammation, it's helping the gut work. Now there's all kinds of other things too that play into that, but that's the genetic piece. Testing for that specific gene or doing the detoxification panel that we offer or Fagran genetics offers is just a great way to support your body, especially if you've struggled with chronic constipation, which is terrible.

Closing Advice and Episode Wrap-Up 21:08

Yes, absolutely. Well, I love that you started off with really creating any type of maybe fear that someone may have around what it could look like. And so is there any last minute before we dive into a lot more of what the bigger picture and what some bigger chronic things could be. Is there any closing comments that you have for just the basics, where people are starting? So basics. Keep yourself hydrated. Eat enough healthy fiber. Move your body. And when you do poop, get your hips, your knees slightly above hip level.

Get on and off. And you don't have to have a squatty potty. We used to telephone books, but we don' anymore. And, you know, listen to your body when you feel like you've got to go. So with your kids, if they're doing that potting dance, hey, honey, let's go to the pot. Let's see what we can do. For your kid, don''t let their legs dangle off the toilet. Get them supported on that little squat. That's it. I love that Dr. K. Thank you. That was Dr Paula Kruppstadt on the basics of childhood constipation from baby stools to why hydration, fiber, and squatting position matters.

Want the free poopy doopy chart, hydration formulas, in our quick checklist? Make sure to check the link in the show notes. Subscribe so you don't miss part two where we uncover chronic causes, genetics,